Religious Barriers Research Articles

Determinants of patient nonattendance in HIV/AIDS suburban clinics: A case study in clinic staff perceptions

ABSTRACT The purpose of this study is to analyze HIV/AIDS clinic staff perceptions of patient nonattendance to develop location-specific strategies for attendance rate improvement. People living with HIV may provide incomplete information regarding their behavior given the culture of secrecy, history of mental illness, and illegal nature of intravenous drug use. Staff perspectives offer insights that the patients may not recognize or be willing to admit. The investigation examined 32 staff interviews, a perspective yet to be explored in depth, at four suburban Midwestern and Southern HIV/AIDS clinics. Thematic analysis revealed five nonattendance determinants: social, cultural, physical, psychological, and logistical. Subthemes not found in previous studies emerged across clinics, including religious and language barriers in the local Hispanic, Burmese, and Haitian Creole populations. The qualitative study yielded previously unknown explanations for patterns in data common in the literature. For example, the staff more often associated the younger generation with feelings of invincibility, but the older generation with limited access to future care due to physical mobility issues. Clinic administration identified a new trend of patients taking temporary holidays from care. Given the differing subthemes, location-specific attendance intervention strategies are proposed.

Senses and Sensibility: Huckleberry Finn's Path to Truth and Freedom

Given that some masterpieces of English literature still conceal aspects that have not been fully explored, this analysis focuses on Mark Twain’s novel "The Adventures of Huckleberry Finn," which remains highly relevant in the context of current global affairs, where discussion on race and tolerance are mainstream. The article argues that the novel's protagonist, Huck, rejects the social programming of his time in favour of freedom, breaking through both social and religious barriers. This work highlights the central role of human senses as the ultimate arbiters of morality and truth in Huck's life. By examining Huck's journey, this analysis emphasizes the profound impact of his intuitive senses in navigating complex moral dilemmas and making ethical decisions. This exploration of sensory perception sheds light on Huck's commitment to moral integrity, revealing the intricate dimensions of human consciousness and ethical judgment. Additionally, the article discusses Mark Twain's effort to challenge and change the prevailing mindset on race. His subtle yet powerful attempt to recalibrate societal views challenges the conventional belief that one's social circumstances dictate their role within the collective, advocating instead for the potential of individuals to transcend societal boundaries and contribute to the pursuit of a more just world.

Connecting the experiences of persons with disabilities and social workers in Nigerian care institutions regarding COVID-19 vaccine uptake: a qualitative descriptive-interpretive design.

During the COVID-19 pandemic, persons with disabilities (PWDs) have faced additional disadvantages that have exacerbated their physical and mental health challenges. In Nigeria, where cultural, religious, and informational barriers persist, understanding these factors is critical for improving health interventions, including vaccine uptake among PWDs. This study employed a qualitative descriptive-interpretive design to explore the perceptions of PWDs regarding the COVID-19 pandemic and the vaccine, alongside social workers' views on their roles in facilitating vaccine uptake. We conducted in-depth semi-structured telephone interviews with 20 participants, comprising 16 PWDs and four social workers in Nigerian rehabilitation homes. Data were analyzed using critical thematic analysis to identify key themes influencing attitudes toward the pandemic and vaccine uptake. The study uncovered significant barriers to COVID-19 vaccine uptake among PWDs, primarily driven by mistrust in government initiatives, widespread conspiracy theories, and deeply held cultural and religious beliefs. Additionally, while social workers played crucial roles as community surveillance officers, in-house educators, and community referral agents, their interventions lacked specific strategies aimed at increasing vaccine uptake among PWDs. Their efforts were more focused on addressing the psychological impacts of the pandemic rather than fostering behavioral changes toward vaccine acceptance. To enhance COVID-19 vaccine uptake among PWDs in Nigerian rehabilitation homes, targeted interventions that address the identified barriers are essential. These should include trust-building measures, culturally and religiously sensitive communication strategies, and tailored educational programs by social workers. Moreover, training social workers in specific, evidence-based strategies to increase vaccine uptake is crucial for mitigating the pandemic's impact on this vulnerable population.

The revered Perumale in Tiruppukal: a case study

Tiruppukal is a devotional poetry composed by poet-saint Arunagirinathar to promote glory of Lord Murugan, the ancient god of Tamils. A preliminary literature review of the text revealed the name Perumale (Perumal), synonymous with names Tirumal and Vishnu among Tamil Vaishanavites, is more often quoted in comparison to Murugan. Thus, this article tries to analyse Arunagirinathar’s intend in promoting name Perumale. This article approaches the subject using qualitative research incorporating library-based and descriptive methods to analyse and evaluate Arunagirinathar’s such intend. Findings revealed that Perumale is a conceptual term means “Great One” or “Lord of Lords” even though has connotation to deity Perumal. The name Perumale is used in social and linguistic contexts to depict Murugan as the Great God of the Tamils. Arunagirinathar also portrayed Murugan’s attributes and his three forms to alleviate Him from the Tamil folklore deity to a Great God of the South India. Arunagirinathar also used Perumale to syncretize Murugan and Skanda to bridge a cultural and religious unity between the North-South (India) while stamping Him with pan-Indian identity. Further, Lord Murugan’s bond of kinship with various divinities and deities of Hindu pantheon in context with name Perumale portrayed Him as Supreme Being in par excellence with Siva and Vishnu as well as illustrates sense of oneness, coexistence and harmonious interaction which binds the various Hindu divides. Thus, Arunagirinathar by means of the Perumale has portrayed Murugan as a pan-Hindu god who transcends religious and philosophical barriers in Hindu pantheon.

Department of History, Ahmadu Bello University, Zaria, Nigeria nanasidi@abu.edu.ng

Abstract. In 1999, the Nigerian government launched its Universal Basic Education (UBE) program to provide free and compulsory education for every Nigerian child. Despite this effort, girls’ enrollment and school retention are still at their lowest ebb. This problem is even more apparent in Northern Nigeria where economic, religious and cultural factors often deny most girls access to education, especially in the NorthWest. Using a qualitative research methodology, this paper assesses the factors debilitating against girl child education in Northern Nigeria between 1999 and 2015 and their implications. This study finds out that factors such as early marriage, gender discrimination, low government support and the condemnation of co-education were responsible for the low enrollment of girls in schools across the Northern region. The paper concludes that to achieve the United Nation’s Millennium Development Goals2 (MDG2) and Sustainable Development Goals-4 (SDG 4), the government, international community, NGOs and parents must put their hands on deck to break the social, economic, religious and cultural barriers denying girls full and equitable access to education in Northern Nigeria. Keywords: Girl child education, Social Inclusion, MDG2, SDG4, Northern Nigeria, Challenges

Process evaluation of comprehensive sexuality education programme in Zambia: a focus on contextual factors, mechanisms of impact, quality of development and implementation process

BackgroundComprehensive sexuality education (CSE) is critical in addressing negative sexual and reproductive health (SRH) outcomes among adolescents. Yet in many low- and middle-income countries (LMICs) including Zambia, little is known about the impact, realities of CSE implementation, the quality of teaching and the comprehensiveness of the content covered.MethodsOur approach was informed by a process evaluation incorporating recommendations by the European Expert Group guidance on evaluating sexuality education programmes and the Medical Research Council (MRC) guidelines on process evaluation. The development process and quality of CSE implementation were assessed using eight and six quality criteria respectively. In-depth interviews (IDIs), focus group discussions (FGDs), document analysis and classroom observation were employed to assess contextual factors, implementation process and mechanisms of impact of CSE. In-depth interviews (50) and focus group discussions (2) with seven pupils in each group were conducted among 64 purposefully selected participants. The sample comprised pupils (35), parents (4) and teachers (17) from nine secondary schools (four peri-urban, four urban and one rural), policymakers (4), and religious leaders (4). We employed deductive content analysis to analyse the data.ResultsContextual factors that influenced the implementation of CSE included: (1) piecemeal funding for the CSE programme; (2) lack of monitoring programmes in schools; (3) lack of community engagement; (4) religious and socio-cultural barriers; (5) lack of skills and competency to teach CSE; and (6) insufficient time allocation for CSE. The assessment of the quality of the development of CSE revealed: (1) a lack of sexual diversity; (2) no meaningful participation of pupils in programme implementation; (3) a lack of stakeholder engagement during programme implementation; (4) lack of gender sensitivity; and (5) lack of human rights approach. Assessment of the quality of the implementation of CSE revealed: (1) no evidence of skill-based CSE teaching; (2) no linkage between CSE and SRH services in the communities; and (3) a lack of incorporation of multiple delivery methods during CSE teaching. The mechanisms of impact of CSE were related to the acceptability and positive changes in pupils’ SRH practices.ConclusionThe complex influences of contextual factors during CSE implementation highlight the need for contextual analysis during the interventional design. Co-creation of the CSE programme through stakeholder participation could reduce social opposition and enable a culturally sensitive CSE. Comprehensive teacher training, a guiding curriculum as well as setting of appropriate monitoring tools and indicators are likely to enhance the quality of CSE implementation.

Assessing Medical Students' Perspectives on Organ Donation: A Cross-Sectional Study.

Background Organ donation is a community service that not only saves lives but also improves the quality of life. The major concerns causing organ shortage in the country are the lack of awareness and correct knowledge among the public and myths and misconceptions clouding organ donation because of religious and cultural barriers. Material and methods A cross-sectional study was conducted among 300 medical students of a private medical college in the Telangana region, India, from July 2019 to October 2019 after approval from the Institutional Ethics Committee (IEC). A total of 300 participants (218 females (72.66%) and 82 males (27.33%)) were included in the study. Respondents completed a three-section questionnaire that included sociodemographic data, 15 questions on knowledge, and 12 questions on the attitude and ethical aspects of organ donation. Statistical tests utilized for investigation were the Student's t-test and one-way ANOVA to compare knowledge and attitude scores. Results The mean knowledge score among the participants was 10.85±1.79, with a P value of 0.45. The mean attitude score concerning organ donation among the participants was 45.5±4.47, with a P value of 0.44. The majority (87.1%) showed a positive attitude in this study. Conclusions The study emphasizes the necessity of interdisciplinary educational interventions for medical students to help them realize the complexities of the problem holistically. Their attitude regarding organ donation is not significantly affected by traditional educational interventions such as lectures and demonstrations. Educated healthcare professionals will play a critical role in motivating the public for the cause of organ donation promotion.

Women’s Participation in Community-Based Adaptation to Climate Change (CBACC): An Intersectional Analysis

This study explores which women participate in community-based adaptation (CBA) from an intersectional perspective. This study followed in-depth interviews (IDIs) and key informant interviews (KIIs) methods for data collection in Latachapli, Bangladesh. It explores women from different ethnic and religious identities participating in community-based adaptation (CBA) activities. The diversity among women leads to varying levels of participation. Three main areas—sense of insecurity, support from family members, and women’s literacy—and the NGO’s administrative bias have been seen to influence different levels of women’s participation in CBA. All these findings suggest that women’s intersectional challenges when participating in activities must be considered. The problem with the NGOs that implement the CBA activities is that they focus on marginalized communities (Rakhine) and women in general without taking into consideration the cultural, religious, and historical barriers that these different women face.

Men’s Involvement in Wives’ Contraceptive Choices: A Comparative Study in Rural and Urban Communities of Akure South Local Government Area

In rural Nigerian communities, men play a crucial role in family planning decisions, often determining if and how their wives can practice contraception. This study aimed to examine the extent of husbands' influence on their wives' contraceptive choices, comparing rural and urban areas in Akure South local government area. The research included a sample of 360 men, using a researcher-developed questionnaire and interview guide for data collection. Descriptive statistics such as frequencies, percentages, means, and standard deviations were used to analyze the data, and chi-square inferential statistics tested the hypothesis at a 0.05 significance level using SPSS version 17. Findings revealed that only 46% of rural respondents participated in family planning practices. Men’s engagement in these activities showed low mean values (2.21, 2.11, 2.25), indicating minimal involvement, primarily due to lack of information (40.5%) and limited contraceptive options (34.8%). Most men used condoms (23.8%), a combination of condoms and withdrawal (27.5%), or vasectomy (13.1%). The study concluded that male participation in family planning was low. To improve this, communities need better access to information, education, and communication. Cultural and religious barriers hindering male involvement in family planning should be addressed, and more male contraceptive options should be made available.

Nurse caring in Iran and its relationship with patient satisfaction

Objective: The aim of this study was to determine the relationship between patients’ reports of nurse caring and patient satisfaction with nursing care. Design: The study used a cross sectional design. The Persian versions of the Revised Caring Behaviors Inventory (CBI) and the Patient Satisfaction Instrument (PSI) were used to establish the strength of association between nurse caring and patient satisfaction with nursing care. Data were analysed using SPSS version 10. Setting: The setting was the educational hospitals affiliated to Iran University of Medical Sciences (IUMS). Heavy workloads and severe staff shortages are common characteristics of Tehran educational hospitals and the time that nurses previously allotted to direct care has been reduced. Subjects: Two hundred and fifty patients who were hospitalised for medical conditions or surgical procedures were selected through a quota sampling method during 2007. Results: The findings indicated a statistically significant relationships between patient reports of nurse caring and satisfaction with nursing care (r=0.72, p=0.000; CI 95%; 178.31‑189.99 for the CBI and 82.81‑86.71 for the PSI). Male patients were more satisfied with nursing care than female patients. Admissions to hospital during the last five years were positively correlated with patients’ perceptions of nurse caring and satisfaction with nursing care. Conclusion: This study which was carried out in Tehran, Iran supports earlier western evidence that nurse caring is associated with patient satisfaction with nursing care. It is important to reflect on the impact of the current health care environment and cultural religion of Iran on caring behaviors of nurses and patient satisfaction with nursing care. Heavy workloads and severe staff shortages are common characteristics of Tehran educational hospitals and the time that nurses previously allotted to direct care has been reduced which may contribute to changes in patients’ perceptions of nurse caring and satisfaction with nursing care possibly reducing the effects of nursing care services. Iranian nurse managers need to consider the religious and cultural barriers to nurse caring and recompense it by providing more human resources.

FERTILTY CARE IN LOW AND MIDDLE INCOME COUNTRIES: Fertility care in low- and middle-income countries.

Infertility affects millions worldwide, with significant medical, financial, and emotional challenges, particularly in low- and middle-income countries (LMICs). Cultural, religious, financial, and gender-related barriers hinder access to treatment, exacerbating social and economic consequences, especially for women. Despite its prevalence, infertility often remains overlooked due to competing health priorities. However, global initiatives recognise infertility as a reproductive health concern, advocating for universal access to high-quality fertility care. In LMICs, limited resources and infrastructure impede access to treatment, prompting people to turn to alternative, often ineffective, non-biomedical solutions. Addressing these challenges requires implementing affordable fertility care services tailored to local contexts, supported by political commitment and community engagement. Emerging technologies offer promising solutions, but comprehensive education and training programs are essential for their effective implementation. By integrating fertility care into broader health policies and fostering partnerships, we can ensure equitable access to infertility treatment and support reproductive health worldwide.

A qualitative analysis of religious coping and participation in patients with head and neck cancer.

e24093 Background: Head and neck cancer (HNC) and its treatment sequelae result in substantial disfigurement, depression, and isolation. Though up to 7 out of 10 cancer patients lean on prayer or other forms of spirituality for support, little is known about the significance of prayer and religious communities for patients with HNC. There is also a dearth of literature on the role of clergy as spiritual support for patients with HNC. In this qualitative study, we explore religious coping and barriers to community engagement both from a patient and clergy perspective. Methods: We purposively sampled ten patients with HNC from a single, comprehensive cancer center and twelve clergy for interviews. Patients were selected from a larger study of religious engagement and symptomatic distress. Clergy were recruited from a network of churches near the cancer center. Both patients and clergy completed semi-structured interviews, which were then transcribed and analyzed by descriptive content analysis. Results: Four main themes emerged from patient interviews: 1) HNC-related physical symptoms (dysphagia, stoma, impaired speech) hindered relationship-building with others and structured religious groups. 2) Most patients used positive religious coping, citing frequent prayer to God for strength during treatment and peace regardless of disease outcome. Few patients used negative religious coping, describing feelings of doubt and abandonment by God. 3) Patients predominantly found spiritual (prayer) and practical comfort (encouragement, phone calls) outside of religious communities through family, physicians, and support groups. 4) Barriers to religious community involvement included physical disability, satisfaction with individual spirituality, and religious community politics. Among clergy, barriers to patient engagement in religious communities included: lack of health literacy to understand patient needs, resource limitations, insufficient hospital emphasis on holistic health, and little awareness of opportunities for aid apart from psychosocial support. Overall, most clergy and patients believed faith to be an integral part of coping with head and neck cancer. Conclusions: Though patients with HNC experienced some isolation due to physical symptoms, many found spiritual support through private practices of prayer or individual relationships. Patient and clergy views on barriers to religious community involvement diverged; many patients felt satisfied with personal practices, and clergy felt distanced from patients. While future research should focus on clinical elicitation of religious coping strategies, our patients suggest the successful adaptation of such strategies to private contexts when faced with physically debilitating cancer diagnoses.

Palliative care education: a nationwide qualitative study of emergency medicine residency program directors in the United Arab Emirates

BackgroundEmergency medicine (EM) physicians routinely care for patients with serious life-limiting illnesses. Educating EM residents to have general skills and competencies in palliative medicine is a global priority. The purpose of this study was to describe the current status of palliative and end-of-life education in EM residency programs in the United Arab Emirates (UAE) and to identify barriers and opportunities to inculcating palliative care (PC) instruction into EM training in a non-Western setting.MethodsUsing the American College of Emergency Medicine’s milestones for Hospice and Palliative Medicine for Emergency Medicine as a question guide, semi-structured interviews were conducted with program directors of all 7 EM residency programs in the UAE from January through July 2023. Qualitative content analysis was conducted to identify recurring themes.ResultsAll program directors agreed that PC knowledge and skills are essential components of training for EM residents but have had variable success in implementing a structured PC curriculum. Six themes emerged, namely the educational curriculum, PC policies and practices, comprehensive PC services, cultural and religious barriers to PC, EM scope of practice, and supporting residents after patient death.ConclusionUAE national EM residency curriculum development is evolving with an emphasis on developing a structured PC curriculum. As EM residencies implement policies and programs to improve care for patients and families dealing with serious illness, future studies are needed to assess the impact of these initiatives on patient quality of life and physician well-being.

Exploring Muslim Communities' Experiences and Barriers While Accessing Assisted Reproductive Technologies: A Scoping Review of International Literature.

This study adopted a scoping review methodology to analyze international literature on the barriers impacting Muslim couples' access to equitable assisted reproductive technologies (ART). A total of 27 studies were included for review. Results show that Muslim communities face several barriers when accessing ART. These include cultural and religious barriers that impacted which aspects of ART couples were open to adopting, diminished quality of care due to low cultural/religious capacity of practitioners, as well as gendered norms which intersect with experiences of ART treatments. Further research, based in western countries, should be conducted to better understand how these contexts can support Muslim patients accessing ART.

Challenges in the Prevention and Management of Adolescent Pregnancy and School Dropout by Adolescent Mothers in South Africa

Owing to the social, economic, health, educational and psychological implications of adolescent pregnancy, there had been many attempts to stop this phenomenon. These efforts, however, do not seem to be succeeding given its acceleration, generally in South Africa. The schooling of many adolescent girls gets disturbed by their pregnancy and others discontinue with schooling postpartum. This exacerbates South Africa’s challenges of unemployment, poverty, intergenerational illiteracy, and general societal vulnerability. The Pregnant Learner Management Policy contributed to the dropout rates as it prohibited adolescent mothers from returning to school before they had spent two years with their babies. It has since been replaced with the National Policy on the Prevention and Management of Learner Pregnancy in Schools, but reintegration remains a challenge. The pregnancy and reintegration challenges are aggravated by institutional, social, economic, cultural, and religious barriers. The pregnancies are due to several factors such as poor and inconsistent uptake of contraceptives, and inadequate parental involvement and guidance on the sexual and reproductive health education of the adolescents. The study used qualitative research techniques to delve deeper into the adolescent pregnancy and school dropout phenomenon; research participants were sampled from the three provinces with the highest number of births that were delivered by adolescents, namely KwaZulu-Natal, Limpopo, and Eastern Cape.

Conscience-Based Barriers to Medical Aid in Dying: A Survey of Colorado Physicians.

Approximately 20% of the United States' population lives in a state or jurisdiction where medical aid in dying (MAiD) is legal. It is unknown how physicians' own barriers are associated with their provision of the spectrum of MAiD services. To measure physicians' religious and/or ethical barriers to providing MAiD services and how such barriers relate to physicians' intentions and behaviors. Three-wave cross-sectional survey fielded in Colorado in 2020-2021. Physicians providing care to patients likely clinically eligible for MAiD according to probabilistic sampling. Physicians self-reported barriers to their own participation in MAiD. We considered large ethical and/or religious barriers to be conscience-based barriers. We measured physicians' self-reported intention to participate and self-reported prior participation in MAiD since it was legalized in Colorado in 2017. We estimated differences in intention and behavior outcomes according to presence of conscience-based barriers, adjusting for physician gender, race/ethnicity, time in practice, and specialty. Among 300 respondents, 26% reported "large" ethical and/or religious barriers to their involvement in MAiD. Physicians with longer time in practice and those identifying as non-White were more likely to report conscience-based barriers to MAiD. Comparing physicians with and without conscience-based barriers to MAiD, we found no difference in ancillary participation (discussing, referring) but significant differences in direct participation (serving as consultant [5% vs. 31%] or attending [0% vs. 22%]). Approximately one-quarter of physicians likely to care for MAiD-eligible patients in Colorado reported religious and/or ethical barriers to MAiD. Despite religious and/or ethical barriers, the vast majority of physicians were willing to discuss MAiD and/or refer patients seeking MAiD services. These data provide important empirical foundation for policy from hospitals and health systems as well as medical specialty groups with official positions on MAiD.

Religious Cooperation in Plural Ghana: Challenges and Ways for Improvement

There is a global call for religious cooperation and tolerance, and it is a non-negotiable necessity for Ghana, through a collective responsibility. This study thus investigated the perspectives of Ghanaians on the religious situation in Ghana. It looked at whether or not Ghana is a “one religion” State, by exploring the existence of several religions in Ghana. The global advocacy for religious cooperation motivated this study to explore some challenges hindering religious cooperation in Ghana, and ways for improvement. Using a mixed methodology of quantitative and qualitative designs, the study sampled 225 individuals ethically from the Faculty of Social Sciences in KNUST, Kumasi, Ghana. Primary data was obtained through questionnaires and interviews. The findings revealed that Christianity, Islam and African Traditional Religion are the three main religions amongst others in Ghana. A majority of 179 respondents indicated that Ghana has plural religions and is not a “one religion” State, hence, a non-negotiable advocacy for religious cooperation. The majority of these advocates are youth within the age brackets of 15-25 years, followed by adults within 36-45 years. Despite challenges hindering religious cooperation in Ghana such as religious, social, cultural and political barriers, the practice of respect, tolerance and value toward one another and interfaith relations, could guarantee some improvement. Therefore, whether Christians, Muslims, Traditionalists or the Other, one has to be and behave religiously inclusive, tolerant, and humble toward the other. Whether in speech or actions, one should give a listening ear to the other. This paper is relevant for peace and interfaith studies. Keywords: Plural Ghana; Religious Cooperation; the Other; Religious Inclusivism; Tolerance

Healthcare Providers՚ Experience of Non-Linguistic Barriers to Healthcare Provision for Official Language Illiterate Patients in Far-North Cameroon Healthcare Centers: A Contribution to Intercultural Communication

Non-linguistic barriers have significant impacts on healthcare provisions. Drawing data from questionnaires administered through simple random sampling to 487 healthcare providers in 45 healthcare centers of the Far-North region of Cameroon, this paper sets out to study healthcare providers՚ experience of non-linguistic barriers to healthcare provision for official language illiterate patients (i.e. patients who lack complete communicative skills in official languages of Cameroon (English and French)). More precisely, the work investigates non-linguistic barriers to healthcare provision in Far-North Cameroon healthcare centers and discusses some remedial strategies. Campinha-Bacote՚s (2002) Cultural Competence of Healthcare Delivery has served as the theoretical framework for the study and the approach of analysis is both quantitative and qualitative. Findings reveal that religious barriers; cultural beliefs, practices, taboos and witchcraft; overdependence on traditional medicine, traditional doctors and soothsayers and exacerbated patriarchy constitute serious hindrance to healthcare provision in the healthcare centers in this region of Cameroon. Current trends and suggestions to limit these barriers include the following: informing, educating, communicating and counselling; familiarization of healthcare providers to the cultural practices of the community; gender-sensitiveness with regard to the caring of patients; referring some patients to colleagues of other healthcare centers; priority to female healthcare providers in women health services; recruiting healthcare providers who are of the locality in which healthcare centers are found and getting substitute product for blood during blood transfusion. It is argued that in addition to these current strategies, a more efficient approach to limit these barriers should incorporate intercultural competence. The paper intents to contribute to the domain of intercultural communication in the context of healthcare provision for official language illiterate patients in multicultural contexts.

The Thudong Bhikkhu Pilgrimage

Thousands of kilometres travelled by 32 thudong monks from Thailand to Indonesia was not only a spiritual moment for the participants but also a historical event in Indonesian interfaith relations. Given the abundance of enthusiasm, this article aims to explain the purity of interfaith harmony created by local communities and Thai monks, who also contributed to promoting interfaith dialogue discourse among grassroots communities. By delving into the internet, a netnography approach is used to get a deeper and broader understanding of the events by comparing one digital document with another. In the interfaith encounters along the pilgrimage highway, both parties exhibited reciprocal behaviours of shared feelings and kindness that encouraged them to complete the ritual mission together. They were able to dismantle the religious barriers that frequently impede harmonious interfaith relations as a result of warm acceptance, hospitable interactions, and engaging dialogue onsite and via social media.

Perceived self-efficacy to teach comprehensive abortion care among nursing and midwifery faculty in higher learning institutions in Rwanda: A mixed method study.

Comprehensive abortion care is an emerging intervention being integrated into nursing and midwifery curricula. Yet, no studies have been conducted in Rwanda to determine whether faculty perceive themselves as capable of teaching comprehensive abortion care. This study aims to evaluate the perceived self-efficacy to teach comprehensive abortion care among nursing and midwifery faculty in higher learning institutions in Rwanda. The University of Rwanda College of Medicine and Health Sciences Institutional Review Board approved this study (UR-CMHS-IRB No 335/CMHSIRB/2022). In quantitative, a self-administered questionnaire was administered to 98 study participants. Data were entered into Statistical Package for the Social Sciences (SPSS) version 26 and analyzed using Chi-square test with a p-value of 0.05 set as the significance level. In the qualitative part, an interview guide was developed based on quantitative data to understand comprehensive abortion care teaching fully. Data were collected from four focus group discussions with eight participants in each group, entered in Dedoose, and analyzed thematically. Among the 98 study participants who were invited to participate in this study, only 85 filled out the questionnaires. This translates into 86.7% of the response rate. More than half 58.8% had adequate self-efficacy in teaching comprehensive abortion care. A Chi-square test has revealed that being a male, being a midwife, and having more years of working experience in nursing education were significantly associated with self-efficacy in teaching comprehensive abortion care (p value <0.05). In the qualitative phase, 32 study participants participated in four focus group discussions and four themes were identified: a) variability in confidence levels to teach comprehensive abortion care; b) readiness about teaching comprehensive abortion care; c) facilitators of teaching comprehensive abortion care; and d) contextual challenges to teach comprehensive abortion care. The findings revealed that faculty's self-efficacy in teaching comprehensive abortion care was not adequate. Personal and religious beliefs and institutional barriers were also reported to hinder self-efficacy in teaching comprehensive abortion care. Therefore, intensive comprehensive abortion care training for nursing and midwifery faculty in higher learning institutions should be provided, including values clarification and attitude transformation training for attitudes and beliefs. It is also critical for higher learning institutions to develop strategies for overcoming the challenges faculty face when teaching comprehensive abortion care.